title: A template approach to quality improvement activity: a primary care example.
abstract: BACKGROUND
  This paper demonstrates the use of a Quality Framework and Implementation Template to review processes for improving the quality and safety of opiate prescribing for chronic non-malignant pain (CNMP). Escalating use of prescription opiates for chronic pain is of national and international concern, with major implications for personal and public health as well as for patient safety and health service quality and safety.
  
  
  OBJECTIVE
  This paper uses opiate prescribing for CNMP as a worked example to illustrate use of the Quality Framework for self-directed quality improvement in smaller specialist medical or community-based practices.
  
  
  METHODS
  An Implementation Template, comprising a series of focussed questions derived from the Quality Framework, was applied to one specific quality improvement activity arising from clinical practice (opiate prescribing for CNMP). This helped the practice team understand current systems and processes, identify actual and potential problems, and find possible solutions to institute interventions for change.
  
  
  CONCLUSIONS
  The template approach to quality activity is very applicable within smaller specialist or community health service settings, enabling such health services to focus on their own quality improvement activities and address topics of importance to the practice in a systematic and productive manner.
authors.affiliation: Horowhenua Community Practice, 62 Liverpool Street, PO Box 50, Levin 5540, New Zealand. Email:
authors.forename: Christopher
authors.initials: C
authors.lastname: Fawcett
authors.forename: Helen
authors.initials: H
authors.lastname: Moriarty
authors.forename: Roshan
authors.initials: R
authors.lastname: Perera
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D017408:Guidelines as Topic; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D061214:Patient Safety; D011320:Primary Health Care / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration*
chemical_list: D000701:Analgesics, Opioid